Clofazimine, leprosy

Leprosy, also referred to as Hansen s disease, is caused by the bacterium Mycobacterium leprae. Although rare in colder climates, this disease may be seen in tropical and subtropical zones. Dapsone and clofazimine (Lamprene) are the two drags currently used to treat leprosy. The leprostatic drugs are listed in the Summaiy Drug Table Leprostatic Dragp. 

Clofazimine is primarily bactericidal against M. leprae. The exact mode of action of this drug is unknown. Clofazimine is used to treat leprosy. 

Mr. York has been prescribed clofazimine daily to manage his leprosy. Discuss what preadministration assessments the nurse should make. Explain what information you would include in a teaching plan for Mr. York. 

A patient with leprosy is prescribed clofazimine 100 mg daily PO. The drug is available in 200-mg tablets. The nurse administers. ... 

Dapsone (diaminodiphenylsulphone Fig. 5.16F) is used specifically in the treatment of leprosy. However, because resistance to dapsone is unfortunately now well known, it is recommended that dapsone be used in conjunction with rifampicin and clofazimine. 

Clofazimine is a substituted iminophenazine that was first proposed for treating leprosy in 1962 however, it entered into medical practice toward the end of the 1980s. The mechanisms of its action is not definitively known, although there is the assumption that it can inhibit the formation of matrixes with DNA, which leads to a delay in the growth of mycobacteria. Clofazimine exhibits a bactericidal effect between that of dapsone and rifampicin. Synonym of this drug is lamprene. 

Agents used for the management of leprosy are dap-sone, rifampicin, clofazimine and recently thalido-... 

Clofazimine has some activity against M. tuberculosis and is used as a last resort drug for the treatment of MDR tuberculosis. It is primarily used in the treatment of M. leprae and M. avium-intracellulare. Further details are discussed later, under the treatment of leprosy. 

Clofazimine is given to treat sulfone-resistant leprosy or to patients who are intolerant to sulfones. It also exerts an antiinflammatory effect and prevents erythema nodosum leprosum, which can interrupt treatment with dapsone. This is a major advantage of clofazimine over other antileprosy drugs. Ulcerative lesions caused by Mycobacterium ulcerans respond well to clofazimine. It also has some activity against M. tuberculosis and can be used as last resort therapy for the treatment of MDR tuberculosis. 

Ethionamide and prothionamide are weakly bacteriocidal against M. leprae and can be used as alternatives to clofazimine in the treatment of MDR leprosy. Both cause GI intolerance and are expensive. 

Use in conjunction with either rifampin or clofazimine to prevent development of drug resistance and reduce infectiousness of patient with leprosy more quickly... 

PABA) incorporation into folic acid (inhibition of folate synthesis). In large proportion of Mycobacterium leprae infections e.g. in lepromatous leprosy, resistance can develop, so combination of dapsone, rifampicin and clofazimine is used in initial therapy. 

Clofazimine is phenazine dye and used as alternative to dapsone in dapsone intolerant/resistant cases and in combination with dapsone and rifampicin in the multidrug treatment of leprosy. It s probable mechanism of action is its involvement in DNA binding, it may interfere with template function of DNA. 

It is antitubercular drug used as an alternative to clofazimine in the treatment of leprosy. But due to its hepatotoxicity, its use in leprosy is very limited. 

Several drugs closely related to the sulfonamides have been used effectively in the long-term treatment of leprosy. The most widely used is dapsone (diaminodiphenylsulfone). Like the sulfonamides, it inhibits folate synthesis. Resistance can emerge in large populations of M leprae, eg, in lepromatous leprosy, if very low doses are given. Therefore, the combination of dapsone, rifampin, and clofazimine is recommended for initial therapy. Dapsone may also be used to prevent and treat Pneumocystis jiroveci pneumonia in AIDS patients. 

Clofazimine is given for sulfone-resistant leprosy or when patients are intolerant to sulfones. A common dosage is 100 mg/d orally. The most prominent untoward effect is skin discoloration ranging from red-brown to nearly black. Gastrointestinal intolerance occurs occasionally. 

Clofazimine is effective against Mycobacterium leprae and is used primarily as an adjunct in the treatment of leprosy. During clofazimine therapy, many patients experience problems with red to brownish-black discoloration of the skin. Although this discoloration is reversible, it may take several months to years before skin color returns to normal. Other adverse effects include abdominal pain, nausea, vomiting, and rough, scaly skin. 

Leprosy (Hansen s disease) is caused by M- leprae. Bacilli from skin lesions or nasal discharges of infected patients enter susceptible individuals via the skin or respiratory tract. The World Health Organization recommends the triple drug regimen, dapsone, clofazimine, and rifampin (see p. 333) for 6 to 24 months. 

Alycobocteriiim leprae (leprosy) Actinomycetes dapsone + rifampicin clofazimine ethionamide or cycloserine... 

Intraneural deposition of a ceroid-like pigment has been seen after treatment of lepromatous leprosy with clofazimine (6). This pigment does not affect the healing process. Treatment can be continued, provided that the dose is not too high. 

Clofazimine can inhibit the liver damage that is associated with lepromatous leprosy and the leprosy reaction it has only minimal or no deleterious effects on Uver function (11). 

McDougall AC, Jones RL. Intra-neural ceroid-like pigment following the treatment of lepromatous leprosy with clofazimine (B663 Lamprene). J Neurol Neurosurg Psychiatry 1981 44(2) 116-20. 

Sukpanichnant S, Hargrove NS, Kachintorn U, Manatsathit S, Chanchairujira T, Siritanaratkul N, Akaraviputh T, Thakerngpol K. Clofazimine-induced crystal-storing histiocytosis producing chronic abdominal pain in a leprosy patient. Am J Surg Pathol 2000 24(l) 129-35. 

In 28 patients with lepromatous leprosy, clofazimine did not influence the urinary excretion of dapsone, except in one case (46). 

Levamisole has been used experimentally in leprosy, particularly in combination with dapsone. This combination was used in a documented series of Indian patients, some currently lepromatous and others in the course of a leprosy reaction (1). When using doses sufficient to provide as good an effect as that obtained with clofazimine + dapsone in a comparison group, adverse effects were limited to gastrointestinal intolerance (which was usually mild), affecting only five of the 30 patients treated an incidental case developed pyrexia. 

Hepatotoxicity of combined therapy for leprosy has been reported in 39 patients treated with dapsone, pro-tionamide, and rifampicin. There were similar findings in 50 patients treated with dapsone, clofazimine, rifampicin, and protionamide. Deaths probably related to the drngs occurred in both groups after 3-4 months of treatment... 

Clofazimine. Clofa/imine (Lamprcne) is a basic red dye that exerts a slow bactericidal efrcct on M. leprae, the baeterium that causes leprosy. It occurs as a dark red crystalline solid that is insoluble in water. 

Clofazimine is used in the treatment of lepromatous leprosy. including dap.sone-resistant forms of the di.sca.se. In sidition to its antibacterial action, the drug appears to possess anti-inflammatory and immune-modulating effects that are of value in controlling neuritic complications and in suppressing erythema nodosum leprosum reactions associated with lepromatous leprosy. It is frequently used in combina-iion with other drugs, such as dapsone or rifampin. 

It has been e.stimatcd that there arc. about 11 million ca.scs of leprosy in the world, of which about 60% are in Asia (with 3.5 million in India alone). The first reports of dapsonc resi.stancc prompted the use of multidrug therapy with dap-.sonc, rifampin, and clofazimine combinations in some geographic iucas. ... 

Dapsone is u.sed in the treatment of both lepromatous and tuberculoid types of lcpro.sy. Dapsone is used widely for all forms of leprosy, often in combination with clofazimine and rifampin. Initial treatment often includes rifampin with dap-.sone. followed by dapsone alone. It is also u.s to prevent the occurrence of multibacillary lcpro.sy when given prophy-lactically. 

Clofazimine, a substituted aminophenazine dye with lepro-static properties (50 to 100 mg p.o. once daily), is indicated in the treatment of dapsone-resistant leprosy and erythema nodosum leprosum. 

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